LVN; Case Manager

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  • 17-00200
  • Full Time/Contract
  • Case Management
  • Long Beach, CA
Job Description
CLIENT COMPANY OVERVIEW
Our client is a Managed Care Health Plan that focuses on providing individuals with Medi-Cal, Medicare or Commercial coverage with convenient access to quality, evidence-based medicine, superior value, exceptional service and a network of integrated providers through multiple contracts with various health plans.

POSITION SUMMARY

LVN; Case Manager
(Managed Care Health Plan)

Essential Functions and Responsibilities

  • Excellent inter-personal skills with the ability to work independently and as a member of team
  • Excellent verbal and written communication skills, plus strong organizational skills with the ability to plan, prioritize and multi-task as well as the ability to understand and create solutions to complex problems.
  • Be at work and be on time
  • Follow company policies, procedures and directives
  • Interact in a positive and constructive manner
  • Prioritize and multitask
  • Process authorization requests
  • Participate in Interdisciplinary conferences regarding complex/special needs population(SNP)
  • Regularly provide overview and updates on SNP membership to CMO/ Dir UM/CM
  • Create Care Plans individualized to member’s needs as established during intake process
  • Improve member’s health status by developing long and short-term goals identified and stratified with member

Essential Job Outcomes

  • Process authorization requests
  • Plan and execute Interdisciplinary Conferences regarding SNP population Regularly provide overview and updates on SNP membership to CMO/ Dir UM/CM
  • Create Care Plans individualized to member’s needs as established during intake process
  • Improve member’s health status by developing long and short-term goals identified and stratified with member
  • Complete and document flexible short term and long-term goals for SNP members
  • Assist members by arranging follow up appointments with PCP/Specialists
  • Assist with transfers of members from facilities or level of care as deemed appropriate and ordered by contracted physician
  • "Other duties as assigned "

QUALIFICATIONS & EDUCATION

  • Current California LVN license without restrictions
  • Certified in Case Management a plus
  • 3-5 years’ experience in managed health care environment; Health Plan, IPA, MSO required
  • 1-2 years’ experience in acute care setting
  • 1-2 years’ experience in SNF or ambulatory setting a plus
  • Bilingual: Spanish speaking preferred
  • Familiar with Microsoft Office: Word, Excel, Power Point

POSITION CLASSIFICATION
Full-Time; Contract to Hire

$32.00/hr


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